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Preventive Maintenance
SIGMA Manual Number 41019
Revision AA
Preventive Maintenance Check Sheet
Serial Number: ______________________ Date:______________________
Software Version:_________________________________
Control Number:_________________________________
Test
Pass
Fail
Visual Inspection
Keyboard Test
Upstream (Proximal) Occlusion Sensor Test
Air Detection Test
Downstream (Distal) Occlusion Sensor Test
___________psi or ___________mm/hg
Memory Test
Flow Rate Accuracy Test
Volume Output ___________mL
Battery Capacity Test
Time “Start to dead” = ______Hrs. ______Min.
Time “Low to dead” = ______Hrs. ______Min.